Advanced prostate cancer


Actuarial survival A method of calculating survival over time.
Adrenal glands Small glands lying on top of the kidneys which produce a small amount of male hormone.
Anaemia A lack of red cells in the blood. It can cause tiredness, paleness, weakness and sometimes heart problems
Androgens Male hormones. The most active male hormone, testosterone, is produced by the testicles. Other male hormones are produced by the adrenal glands.
Androgen deprivation therapy (ADT) Medical or surgical castration, anti-androgens or oestrogens.
Anti-androgens Drugs that block the effects of male hormones.
Asymptomatic Asymptomatic Not having symptoms, symptom-free.
Benign Not cancerous
Benign prostate enlargement Non-cancerous enlargement of the prostate. Overgrowth of normal prostate tissue.
Bisphosphonates A class of drugs that prevent the loss of bone mass.
Bone scan A test in which a radioactive chemical is injected, then x-rays trace its path throughout the body. The chemical goes to parts of the bone which are abnormal, such as areas of cancer, infection or arthritis. Bone scans can be unreliable and so are often used to give guidance, rather than answers, to a problem.
Benign prostatic hyperplasia (BPH) A condition causing non-cancerous enlargement of the prostate.
Biopsy of the prostate Biopsy of the prostate Removal of small pieces of tissue, in this case, from the prostate. Tissue samples are taken from different areas of the prostate, and then examined under the microscope to see if they are cancerous.
Brachytherapy A type of radiotherapy of the prostate. Involves the insertion of radioactive seeds directly into the prostate which are retained (low-dose brachytherapy). An alternative form (high-dose brachytherapy) involves treatment by temporary insertion of radio-active catheters into the prostate.
Complementary and alternative therapies Complementary medicine is any intervention that is used in conjunction with standard western health practices.

Integrative medicine is an approach that combines standard western health interventions and evidence based complementary medicines.

For example: the use of a course of relaxation therapy in conjunction with standard radiotherapy or chemotherapy regime to reduce stress

For example: the use of a course of relaxation therapy in conjunction with standard radiotherapy or chemotherapy regime to reduce stress

Alternative medicine is an intervention or product offered as an alternative treatment to standard western medical practices.

Castrate-resistant prostate cancer Progressive disease despite castrate levels of testosterone.
Computed tomography (CT, also CAT Scan) A series of x-ray pictures are taken in a circle around the body which are processed by a computer.
Combined androgen blockade (CAB) Anti-androgen and medical or surgical castration.
Complete remission (also, complete response) This is the term used when, after treatment, there is no sign of any cancer. It is not necessarily the same as ‘cure’, as some cancer cells may be hidden.
Confidence interval (CI) Quantifies the uncertainty in measurement. When reported as 95% CI, it is the range of values within which we can be 95% sure that the true value for the whole population lies.
Coping strategies Mental strategies or behaviours used to help a person deal with stressful situations. Coping strategies may be influenced by personality style and the specific situation, and may change over time.
Cystitis Inflammation of the bladder, often caused by infection.
Cystoscope A tiny tube with a lighted end which slides along the urethra and is used to examine the bladder.
Depression A general and long-lasting feeling of being down, often associated with tearfulness, guilt or irritability. Other features include loss of interest or pleasure in activities, lowered energy levels, poor concentration and troubles with sleep and appetite.
Digital rectal examination (DRE) An examination of the prostate through the wall of the rectum. The doctor inserts a finger in the rectum and feels the shape of the prostate. Irregularities may be caused by cancer.
Dissemination The act of communicating, distributing or spreading a message or piece of information. The term ‘passive dissemination’ is often used to refer to the distribution, by hand or in mass mailings, of printed education materials, such as clinical practice guidelines.
Dry ejaculation After a radical prostatectomy, a man may achieve orgasm, but produce no ejaculate. This is because the glands which produce much of the fluid in the ejaculate are removed. See also reverse ejaculation
Effectivenesss The extent to which a specific intervention, when used under ordinary circumstances, does what it is intended to do.
Ejaculate Fluid produced at ejaculation, which contains sperm and secretions from glands such as the prostate, seminal vesicles and testicles.
Evaluation A formal appraisal, using quantitative and/or qualitative data, of the value of a project or program against a standard or set of specified criteria. An evaluation may be done internally or by an independent body. The purpose of the evaluation will determine whether it is designed to assess process, outcome or impact.
Evidence Data on the effectiveness of a treatment or intervention derived from studies that compare it with an appropriate alternative. Preferably the evidence is derived from a good-quality randomised controlled trial, but it may not be. In areas of medicine that do not involve a therapeutic intervention, such as diagnosis, prognosis, aetiology and screening, evidence constitutes knowledge derived from properly conducted clinical or health services research.
Evidence-based guideline A statement that is based on scientific literature, explicitly documents the process used to develop the statement, and grades the strength of the evidence used in making clinical recommendations.
Five-year survival rate A scientific measure used to determine the success of a treatment. It measures the number of people who are alive five years after a particular treatment. It does not mean the patient will only live for five years after having treatment.
General anaesthetic A drug given to stop a person feeling pain. A general anaesthetic causes temporary loss of consciousness.
Gleason score A way of grading cancer cells. Low-grade cancers (Gleason score 2, 3, 4) are slower growing than high-grade (Gleason scores 8, 9, 10) cancers.The pathologist identifies the two most common tissue patterns and grades them from 1 (least aggressive) to 5 (most aggressive). The Gleason score is given as two numbers added together to give a score out of ten (for example, 3 + 4 = 7). The first number is the most common pattern seen under the microscope and the second number is the next most common.
Grade A way of describing how abnormal the cancer cells look, and consequently how aggressive or fast-growing the cancer is likely to be.The most commonly used grading system is the Gleason score, which ranges from 2 to 10 (see above).
Hazard ratio A measure of how often a particular event happens in one group compared to how often it happens in another group, over time. In cancer research, hazard ratios are often used in clinical trials to measure survival at any particular moment in a group of patients who have been given a specific treatment or a placebo. A hazard ratio of one means that there is no difference in survival between the two groups. A hazard ratio of greater than one or less than one means that survival was better in one of

the groups.

Hormone resistance Prostate cancer cells are dependent on testosterone or male hormone for growth. Withdrawal of male hormone by surgery or by means of drugs is therefore a means of controlling its growth. However, cancer cells may develop which do not need testosterone for growth. The cancer is then said to be ‘hormone resistant’.
Hormones Natural chemical substances that are produced by one body organ, and travel through the bloodstream to other organs where they exert their effects. A well-known example is insulin, which regulates the blood sugar level.
Hot flush A sudden rush of heat to the face, neck and sometimes chest and back. It can be associated with hormone therapy for prostate cancer.
Hyperthermia Higher than normal temperature. In the case of prostate cancer, a way of destroying tissue by heating.
Impotence Inability to achieve an erection firm enough for penetration.
Incidence The number of new cases of a disease or condition among a certain group of people within a certain period of time.
Incontinence Inability to hold or control the loss of urine or faeces.
Indolent Refers to the type of cancer cells which grow only slowly.
Intervention An action that produces an effect or that is intended to alter the course of a process.
Karnofsky Performance Scale A scale assigning scores from 0 (non-functioning or dead) to 100 (totally normal function).
Luteinising hormone releasing hormone (LHRH) This is produced by the hypothalamus in the brain and stimulates the pituitary (another part of the brain) to produce LH (luteinising hormone). This, in turn causes cells in the testicles to produce testosterone, the male hormone.
LHRH agonists Drugs that interfere with the production of LH (see above) by the pituitary.
Libido Sex drive.
Local anaesthetic The technique of making a small part of the body numb so that minor operations can be performed without pain while allowing the patient to remain awake.
Locally recurrent Cancer that has recurred (come back) after treatment, but which is confined to the prostate or nearby tissues only.
Lymph A clear, sometimes faintly yellow fluid containing white cells, that is collected from the tissues throughout the body, flows in the lymphatic vessels (through the lymph nodes), and is eventually added to the venous blood circulation.
Lymph glands Lymph nodes
Lymph nodes Small, generally pea-sized pieces of tissue found all over the body but easier to feel in the neck, armpits, and groins. Lymph nodes act as filters for foreign substances and commonly become inflamed if there is an infection nearby. They can also harbour cancer cells that have spread from elsewhere.
Malignant Cancerous
Margin-positive See Surgical margins
Maximal androgen blockade Another term for combined androgen blockade (CAB).
Medical oncologist A specialist in the treatment of cancer who uses chemotherapy
Metastasis The secondary or distant spread of cancer, away from its primary (initial) site in the body.
Metastatic Relating to secondary cancer.
Monitoring The process in which patients are followed up after initial diagnosis and treatment. Monitoring may include clinical examination and/or the regular performance of tests.
Magnetic resonance imaging (MRI) A way of imaging the inside of the body using magnetic forces and without using x-rays.
Nodules Small lumps
Oncologist A specialist in the treatment of cancer.
Orchidectomy (also orchiectomy) A type of operation which removes the testicles, but usually leaves the scrotal sac or scrotum.
Partial remission (or response) The situation when, following treatment, signs of the disease process have partially resolved but have not disappeared completely.
Pelvis/pelvic The area of the body below the waist and surrounded by the hip and pubic bones.
Pituitary Part of the brain which produces the hormones that stimulate the testicles to produce testosterone (male hormone) and other hormones.
Primary The site where the cancer began.
Prognosis The course and likely outcome of a disease, as estimated by a person’s doctor or treatment team.
Prostatectomy An operation to remove all or part of the prostate
Prostatitis Inflammation of the prostate. It can be caused by bacteria.
Protocol A well-defined program for treatment.
Prostate specific antigen(PSA ) A protein produced by the cells in the prostate, which is usually found in the blood in larger amounts when prostate cancer is present. It can be used as a test for prostate cancer or to monitor its recurrence.
Psychosocial Referring to the emotional, psychological, social and spiritual aspects of human life.
Quality of life (QOL) . A person’s overall appraisal of his or her situation and wellbeing.
Radiation oncologist A specialist in the treatment of cancer using x-ray techniques.
Radical prostatectomy An operation which removes the prostate and the seminal vesicles. This is usually done through a cut in the lower abdomen.
Radiotherapy The use of radiation as x-rays or electrons to kill tumour cells.
Rectum The last part of the bowel, leading to the anus, and through which stools pass.
Recurrence The re-occurrence of cancer some time after it was first treated.
Reliability (of a test) The ability to measure something in a reproducible and consistent fashion.
Response A change in the size or extent of disease due to treatment.
Retrograde ejaculation Also called reverse ejaculation. This may occur after surgery for benign conditions of the prostate. The ejaculate travels back into the bladder instead of exiting out through the penis. This means a man is usually infertile (cannot produce offspring in the conventional way), but he can still achieve orgasm.
Scrotum A pouch of skin which contains the testicles and some other parts of the male reproductive system. It hangs outside the body and below the penis.
Seminal vesicles Glands that lie very close to the prostate and produce secretions which form part of the ejaculate.
Staging The process of determining the extent of the disease. A system for describing how far the cancer has spread. The most common is the TNM system described in Appendix 3.

A second and older system sometimes referred to, is the Jewett system:

Stage A—Prostate cancer that began and is found in the prostate only. Divided into two stages.

Stage B—Prostate cancer began in the prostate and is more advanced than Stage A.

Stage C—Prostate cancer that began in the prostate, has grown beyond the outer layer of the prostate to nearby tissues, and may be found in seminal vesicles (glands that help produce semen).

Stage D—Prostate cancer that began in the prostate and has spread lymph nodes or far from the prostate, or to other parts of the body, often to the bones.

Each stage is divided into subgroups, which may be viewed at <> accessed 8 July 2009.

Stricture Scar tissue which obstructs fluid flow. In the case of a urethral stricture, urine flow is obstructed.
Support People on whom the patient can rely for emotional caring, and reinforcement of a sense of personal worth and value. Other components of support may include practical help, guidance, feedback and someone to talk to.
Surgical margins After a radical prostatectomy, the edges of the tissue which has been removed are examined to see if cancer cells are present. If they are not (negative surgical margins) the chance is higher that all of the cancer has been removed.
Survival — disease free The proportion of people surviving to a given time, such as five years, without evidence of disease.
Survival — prostate cancer specific The proportion of people who do not die of prostate cancer in a given period, such as five years.
Systemic Relating to the whole body.
Systematic review A review of a clearly formulated question that uses systematic and explicit methods to identify, select and critically appraise the relevant literature, and to collect and analyse data from the studies that are included in the review. Statistical methods (meta-analysis) may or may not be used to analyse and summarise the results of the included studies.
Testicles Glands which produce sperm and the male hormone, testosterone. They are found in the scrotum.
Testosterone The major male hormone. It is produced by the testicles.
Trans-rectal ultrasound (TRUS ) A means of imaging the prostate in order to locate cancer. The ultrasound probe is placed in the rectum
Tumour Any swelling. In the context of cancer, the word usually refers to malignant (cancerous) lumps.
Trans-urethral resection of the prostate (TURP) This is a common operation for benign enlargement of the prostate, but only occasionally used to treat prostate cancer. An instrument is inserted, under anaesthetic, along the urethra (urine tube) and removes prostate tissue which may be blocking the flow of urine.
Urethra The tube which carries urine and ejaculate along the length of the penis and to the outside.

This glossary is adapted from the Clinical Practice Guidelines: evidence-based information and recommendations for the management of localised prostate cancer. A report of the Australian Cancer Network Working Party on management of localised prostate cancer. October 2002, NHMRC, Canberra.

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